Mark Ray A. Espinoza BSN 4 NF Ms.
Jean Karla Penecilla, BSN, RN
10 EMERGENCY DRUGS
NAME OF DRUG
Atropine
DRUG DOSAGE
DRUG CLASSIFICATION
MECHANISM OF ACTION
Inhibits the action of acetylcholine by competing with acetylcholine for common binding sites on muscarinic receptors, which are located on exocrine glands, cardiac and smooth muscle-ganglia and intramural neurons. This action blocks all muscarinic effects.
INDICATION
Cardiopul-monary resuscitation for treatment of sinus bradycardia accompanied by hemodynamic compromise
SIDE EFFECTS
Dry mouth, nose and throat may be severe, decreases sweating, constipation, irritation at site of injection
CONTRAINDICATION
Bladder neck obstruction due to prostatic hypertrophy, cardiospasm, intestinal atony, myasthenia gravis, narrow-angle glaucoma, obstructive disease of GI tract, paralytic ileus, tachycardia secondary to cardiac insufficiency or thyrotoxicosis.
NURSING PRECAUTION
Instruct pt to void before giving medications Determine if patient is hypersen-sitive to medication Monitor v/s and tachycardia Monitor I&O and bowel movement.
0.5-1mg q5min Acetylcholine not to exceed antagonist; 2mg or 0.4mg/kg Antiarrythmic; Antispasmodic, Antidote
Diazepam ranges from a Benzodiazepine; total of 6 anitconvulsant milligrams (mg) to 40 mg per day
Depresses all levels of the CNS by enhancing the action of gammaaminobutyric acid, a major inhibitory neurotrans-mitter in the brain.
For seizures
Pain with IM injection, somnolence, fatigue. ataxia
Angle-closure glaucoma, pre-existing Assess BP, pulse, CNS depression, respiratory respirations depression, severe uncontrolled pain. immediately before adminis-tration. Patient must remain recumbent for upto 3 hrs after parenteral admin. To reduce hypotensive effect. Observe recurrence of seizure activity. Promote safety precautions. Second- or third-degree AV block Monitor BP and cardiac (except in patients with functioning rhythm during and after artificial pacemaker); sinus node adminis-tration. disease, such as sick sinus syndrome Monitor for transient or symptomatic bradycardia (except in asystole. patients with functioning artificial pacemaker); known hypersensitivity to adenosine; known or suspected Inform patient to report bronchocon-strictive or the following symptoms bronchospastic lung disease (when to health care provider:
Adenosine
6mg initial dose
Antiarrhythmic agent, Adenosine is an endogenous purine In vivo diagnostic aid nucleoside that modulates many physiological processes. Cellular signaling by adenosine occurs through four known adenosine receptor subtypes (A1, A2A, A2B, and A3)
Conversion to sinus rhythm of paroxysmal supraven-tricular tachycardia (PSVT), including that associated with accessory bypass tracts (Wolff-Parkinson-White Syndrome)
temporary rash on the chest, lighthea-dedness, diaphoresis, or nausea after administration of adenosine due to its vasodilatory effects. Metallic taste is a hallmark side effect of adenosine administration.
use as a diagnostic aid).
chest pressure, dizziness, facial flushing, headache, light-headedness, numbness or nausea, shortness of breath, tingling in arms.
Amiodarone PO 800Cardiac agent, 1600mg/day in 2- Antiarrhthmic 4 divided doses for 1-3 wks.
Prolongs duration of myocardial cell action potential and refractory period by acting directly on all cardiac tissue.
Life-threatening recurrent ventricular fibrillation, hemodynamically unstable ventricular tachycardia.
Corneal microdeposits if treatment is 6months. Hypotension, nausea, fever, bradychardia
Bradycardia-induced syncope, second- Assess Bp and apical and third-degree AV block, severe pulse before adminishepatic disease, severe sinus-node tering. Withhold if dysfunction. pulse is 60 below or systolic BP is less than 90. Monitor for symptoms of pulmonary toxicity and dosage should be stopped or reduced if toxicity occurs. Monitor EKG, serum AST, ALT, alkaline phosphatase for evidence of hepatic toxicity. Report Shortness of breath, cough Protect against photosen-sitivity. Adas-stokes syndrome, hypersensitivity to amide-type local anesthetics, septicemia, supraventricular arrhythmias, WolffParkinson-White syndrome. Monitor EKG, v/s especially pulse and BP during and following drug adminis-tration for cardiac perform-ance. Inform physician if theres arrhythmias Monitor for drowsiness. Its a sign for high serum levels of lidocaine
Lidocaine
300mg. May repeat in 6090min.
Amide Anesthetic; Antiarrhythmic, Anesthetic
Inhibits conduction of nerve impulses; causes temporary loss of feeling and sensation. Also an antiarrhythmic that decreases depolarization, automacity, excitability of the ventricle during diastole by direct action.
Rapid control of Acute IM: pain at injection site. Ventricular Arrhythmia Topical: burning, stinging, after an MI tenderness at application site
Digoxin
Tablets, oral 125 Cardiac glycoside mcg (0.125 mg) - Tablets, oral 250 mcg (0.25 mg)
Digoxin increases the strength and vigor of heart contractions, and is useful in the treatment of heart failure. It is extracted from the
Digoxin is used for mild nausea, vomiting, Ventricular fibrillation; This medication is best to moderate congestive headache, dizziness, skin hypersensitivity to digoxin or to other taken on an empty heart failure and for rash, and mental changes. digitalis preparations. stomach one hour treating an abnormal before or two hours
- Solution, pediatric, oral 50 mcg/mL (0.05 mg/mL)
leaves of a plant called digitalis heart rhythm called lanata. Digoxin increases the force atrial fibrillation. of contraction of the muscle of the heart by inhibiting the activity of an enzyme (ATPase) that controls movement of calcium, sodium and potassium into heart muscle.
after meals. It may be taken with food if stomach upset occurs. Tell your doctor if you have a history of: liver or kidney disease, lung disease, thyroid problems, rheumatic fever. Headache, ectopic beats, tachycardia, anginal pain, palpitations, vasoconstriction, hypotension, nausea, vomiting, dyspnea. Pheocro-mocytoma, sulfite sensitivity, Monitor for cardiac uncorrected tachyar-rythmias, arrhthmias. ventricular fibrillation. Measure urine output frequently. Immediately infiltrate the affected tissue if extrava-sation occurs. Monitor v/s q15 during adminis-tration. Assess cardiac output, pulmonary wedge pressure or CVP frequenlty. Be alert to excessive vasocon-striction Cardiac arrythimias, cerebro-vascular Monitor for v/s insufficiency, hypertension, hyperthy- changes. roidism, ischemic heart disease, Monitor ABGs narrow-angle glaucoma, shock Monitor EKG and patients condition in Cardiac Arrest. Avoid use of excessive Caffeine derivatives None known. Caution for seizure, migraine, asthma, vascular disease, renal/ cardiac disease, goiter Establish baselines for weight, BP, pulse, serum electrolytes, urine specific gravity. Monitor I&O Withhold medication and report if theres any chest pain or allergies.
Dopamine IV 1mcg/kg/min Simpathomimetic; up to Cardiac stimulant, 50mcg/kg/min vasopressor. titrated to desired response.
Stimulates adrenergic receptors. Increses renal blood flow, urine flow, and sodium excretion. Increases myocardial contractility, stroke volume and cardiac output.
Prophylaxis and treatment for acute hypotension, shock, low cardiac output, CHF
Epinephrine 1mg. May repeat Sympatho-mimetic; q3-5min Bronchodilator; Cardiac Stimulant; Antihem-morrhagic; Antiallergic
Stimulates alpha-adrenergic receptors causing vasocon-striction and pressor effects, beta1adrenergic receptors, rresulting in cardiac stimulation, and beta2adrenergic receptors, resultin in bronchial dilation and vasodilation. Causes peristalsis and vasoconstriction.
Cardiac arrest, Hypersen-sitivity, broncho-spasm
Tachycardia, palpitations, nervousness
Pitressin
V 5units initially. Subsequent doses: 10units q3-4h
Posterior Pituitary Hormone, Vassopressor
Cardiac Arrest, Vasodilatory shock, GI hemorrhage
Pain at injection site, abdominal cramps, nausea, vomiting, diarrhea, dizziness, diaphoresis
Narcan
IV, IM, Narcotic antagonist; Subcutaneous: Antidote. 0.4-2mg q2-3min as needed
Displaces opioids at opioid-occupied For opioid toxicity, None known; little or no receptor sites in the CNS. Reverses opiod-induced pharmacologic effect in opioid-induced sleep or sedation, respiratory depression. absence of narcotics. increases RR, raises BP to normal range.
Respiratory depression due to nonopioid drugs
Maintain clear airway. Obtain weight of children to calculate drug dosage. Monitor v/s. Assess for increase pain with reversal opiate. Observe pt for satisfactory response.
